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Intratympanic gadolinium magnetic resonance imaging supports the role of endolymphatic hydrops in the pathogenesis of immune-mediated inner-ear disease

Published online by Cambridge University Press:  11 June 2018

D Lobo ,
M Tuñón ,
I Villarreal ,
B Brea  and
J R García-Berrocal
D Lobo*
Affiliation:
Department of Otolaryngology, Hospital Universitario El Escorial, Universidad Francisco de Vitoria, Madrid, Spain
M Tuñón
Affiliation:
Department of Radiology, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, Spain
I Villarreal
Affiliation:
Department of Otolaryngology, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, Spain
B Brea
Affiliation:
Department of Radiology, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, Spain
J R García-Berrocal
Affiliation:
Department of Otolaryngology, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, Spain
*
Address for correspondence: Dr D Lobo, Department of Otolaryngology, Hospital Universitario Marqués de Valdecilla, Avenida Valdecilla 25, Santander 39008, Spain E-mail: [email protected]
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Abstract

Objective

To evaluate the presence of endolymphatic hydrops in patients with immune-mediated inner-ear disease.

Methods

The presence of endolymphatic hydrops was prospectively evaluated in 17 patients clinically diagnosed with secondary (n = 5) or primary (n = 12) immune-mediated inner-ear disease, who attended the ENT department of a tertiary care centre for evaluation or treatment over the previous year. All patients underwent magnetic resonance imaging of the temporal bone.

Results

Intratympanic gadolinium three-dimensional magnetic resonance imaging diagnosed hydrops in 11 of 12 patients with primary immune-mediated inner-ear disease (92 per cent). Of these, seven patients (64 per cent) presented only cochlear (n = 5) or predominantly cochlear (n = 2) hydrops. A positive magnetic resonance imaging result was observed in only one of five patients with secondary immune-mediated inner-ear disease (20 per cent).

Conclusion

This study confirms the presence of endolymphatic hydrops in immune-mediated inner-ear disease patients. The virtual absence of hydrops in patients with secondary immune-mediated inner-ear disease is remarkable, although firm conclusions cannot be drawn; this should be explored in a multicentre study with a larger sample of patients. A different immune reaction without development of endolymphatic hydrops should not be ruled out in secondary immune-mediated inner-ear disease patients.

Keywords

AutoimmunityEar, InnerEndolymphatic HydropsHearing Loss, SensorineuralMagnetic Resonance Imaging
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 6 , June 2018 , pp. 554 - 559
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Dr D Lobo takes responsibility for the integrity of the content of the paper

References

1Bovo, R, Ciorba, A, Martini, A. The diagnosis of autoimmune inner ear disease: evidence and critical pitfalls. Eur Arch Otorhinolaryngol 2009;266:37–40CrossRefGoogle ScholarPubMed
2García-Berrocal, JR, Trinidad, A, Ramírez-Camacho, R, Lobo, D, Verdaguer, JM, Ibañez, A. Immunologic work-up study for inner ear disorders: looking for a rational strategy. Acta Otolaryngol 2005;125:814–18Google Scholar
3Naganawa, S, Satake, H, Kawamura, M, Fukatsu, H, Sone, M, Nakashima, T. Separate visualization of endolymphatic space, perilymphatic space and bone by a single pulse sequence; 3D-inversion recovery imaging utilizing real reconstruction after intratympanic Gd-DTPA administration at 3 Tesla. Eur Radiol 2008;18:920–4Google Scholar
4Jung, DH, Nadol, JB Jr, Folkerth, RD, Merola, JF. Histopathology of the inner ear in a case with recent onset of Cogan's syndrome: evidence for vasculitis. Ann Otol Rhinol Laryngol 2016;125:20–4Google Scholar
5Tuñón, Gómez, M, Lobo Duro, DR, Brea Álvarez, B, García-Berrocal, JR. Diagnosis of endolymphatic hydrops by means of 3 T magnetic resonance imaging after intratympanic administration of gadolinium. Radiologia 2017;59:159–65Google Scholar
6Lobo, D. Biological therapies in immune-mediated disease of the inner ear. Clinical-experimental study with etanercept [in Spanish]. Madrid: Universidad Autónoma de Madrid, 2013Google Scholar
7Nakashima, T, Naganawa, S, Sugiura, M, Teranishi, M, Sone, M, Hayashi, H et al. Visualization of endolymphatic hydrops in patients with Meniere's disease. Laryngoscope 2007;117:415–20Google Scholar
8Naganawa, S, Sugiura, M, Kawamura, M, Fukatsu, H, Sone, M, Nakashima, T. Imaging of endolymphatic and perilymphatic fluid at 3 T after intratympanic administration of gadolinium-diethylene-triamine pentaacetic acid. Am J Neuroradiol 2008;29:724–6Google Scholar
9Baráth, K, Schuknecht, B, Naldi, AM, Schrepfer, T, Bockisch, CJ, Hegemann, SC. Detection and grading of endolymphatic hydrops in Menière disease using MR imaging. AJNR Am J Neuroradiol 2014;35:1387–92Google Scholar
10Liu, F, Huang, W, Meng, X, Wang, Z, Liu, X, Chen, Q. Comparison of noninvasive evaluation of endolymphatic hydrops in Meniere's disease and endolymphatic space in healthy volunteers using magnetic resonance imaging. Acta Otolaryngol 2012;132:234–40Google Scholar
11Louza, J, Krause, E, Gürkov, R. Hearing function after intratympanic application of gadolinium-based contrast agent: a long-term evaluation. Laryngoscope 2015;125:2366–70Google Scholar
12Hornibrook, J, Flook, E, Greig, S, Babbage, M, Goh, T, Coates, M et al. MRI inner ear imaging and tone burst electrocochleography in the diagnosis of Ménière's disease. Otol Neurotol 2015;36:1109–14Google Scholar
13Okuno, T, Sando, I. Localization, frequency and severity of endolymphatic hydrops and the pathology of the labyrinthine membrane in Meniere's disease. Ann Otol Rhinol Laryngol 1987;96:438–45Google Scholar
14Fiorino, F, Pizzini, FB, Beltramello, A, Barbieri, F. Progression of endolymphatic hydrops in Meniere's disease as evaluated by magnetic resonance imaging. Otol Neurotol 2011;32:1152–7Google Scholar
15Pender, DJ. Endolymphatic hydrops and Ménière's disease: a lesion meta-analysis. J Laryngol Otol 2014;128:859–65Google Scholar
16Huppert, D, Strupp, M, Brandt, T. Long term course of Meniere's disease revisited. Acta Otolaryngol 2010;130:644–51CrossRefGoogle ScholarPubMed
17Wu, Q, Dai, C, Zhao, M, Sha, Y. The correlation between symptoms of definite Meniere's disease and endolymphatic hydrops visualized by magnetic resonance imaging. Laryngoscope 2016;126:974–9Google Scholar
18Morita, N, Cureoglu, S, Nomiya, S, Nomiya, R, Joglekar, SS, Harada, T et al. Potential cause of positional vertigo in Méniere's disease. Otol Neurotol 2009;30:956–60Google Scholar
19Ito, T, Kitahara, T, Inui, H, Miyasaka, T, Kichikawa, K, Ota, I et al. Endolymphatic space size in patients with Meniere's disease and healthy controls. Acta Otolaryngol 2016;136:879–82CrossRefGoogle ScholarPubMed
20Rarey, KE, Davis, LE. Temporal bone histopathology 14 years after cytomegalic inclusion disease: a case study. Laryngoscope 1993;103:904–9Google Scholar
21Huygen, PL, Admiraal, RJ. Audiovestibular sequelae of congenital cytomegalovirus infection in 3 children presumably representing 3 symptomatically different types of delayed endolymphatic hydrops. Int J Pediatr Otorhinolaryngol 1996;35:143–54Google Scholar
22Fukuda, S, Keithley, EM, Harris, JP. The development of endolymphatic hydrops following CMV inoculation of the endolymphatic sac. Laryngoscope 1988;98:439–43Google Scholar
23Sone, M, Schachern, PA, Paparella, MM, Morizono, N. Study of systemic lupus erythematosus in temporal bones. Ann Otol Rhinol Laryngol 1999;108:338–44CrossRefGoogle ScholarPubMed
24Kariya, S, Kaya, S, Hizli, Ö, Hizli, P, Nishizaki, K, Paparella, MM et al. Cochlear histopathologic findings in patients with systemic lupus erythematosus: a human temporal bone study. Otol Neurotol 2016;37:593–7Google Scholar
25Harris, JP. Experimental autoimmune sensorineural hearing loss. Laryngoscope 1987;97:63–76Google Scholar